{% extends 'layouts/public_base.html' %} {% load i18n %} {% block title %}{% trans "Submit Complaint" %} - PX360{% endblock %} {% block extra_css %} {% endblock %} {% block content %}
{% trans "Home" %}

{% trans "Submit a Complaint" %}

{% trans "We're sorry to hear about your experience. Please select the hospital where the incident occurred." %}

{% trans "Patient" %}

{{ patient.get_full_name }}

{% trans "Select Hospital" %}

{% if hospitals %} {% for h in hospitals %}

{{ h.hospital__name }}

{% if h.hospital__name_ar %}

{{ h.hospital__name_ar }}

{% endif %}
{{ h.visit_count }} {% trans "visits" %}
{% endfor %} {% else %}

{% trans "No visits found for this patient" %}

{% endif %}
{% endblock %} {% block extra_js %} {% endblock %}